Provider Demographics
NPI:1861454290
Name:ROWAN FAMILY PHYSICIANS P L L C
Entity Type:Organization
Organization Name:ROWAN FAMILY PHYSICIANS P L L C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:D
Authorized Official - Last Name:DILORETO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-637-3373
Mailing Address - Street 1:650 JULIAN RD
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28147-9078
Mailing Address - Country:US
Mailing Address - Phone:704-637-3373
Mailing Address - Fax:704-637-0069
Practice Address - Street 1:650 JULIAN RD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28147-9078
Practice Address - Country:US
Practice Address - Phone:704-637-3373
Practice Address - Fax:704-637-0069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-03
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0220BOtherBLUE CROSS BLUE SHIELD NC
NC890220BMedicaid
NCCL6267OtherRAILROAD MEDICARE PALMETT
NC0220BOtherBLUE CROSS BLUE SHIELD NC
NC0480730001Medicare NSC